Document Detail

Particulate air pollution and risk of ST-segment depression during repeated submaximal exercise tests among subjects with coronary heart disease: the Exposure and Risk Assessment for Fine and Ultrafine Particles in Ambient Air (ULTRA) study.
MedLine Citation:
PMID:  12186796     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Daily variations in ambient particulate air pollution have been associated with cardiovascular mortality and morbidity. We therefore assessed the associations between levels of the 3 main modes of urban aerosol distribution and the occurrence of ST-segment depressions during repeated exercise tests. METHODS AND RESULTS: Repeated biweekly submaximal exercise tests were performed during 6 months among adult subjects with stable coronary heart disease in Helsinki, Finland. Seventy-two exercise-induced ST-segment depressions >0.1 mV occurred during 342 exercise tests among 45 subjects. Simultaneously, particle mass <2.5 microm (PM2.5) and the number concentrations of ultrafine particles (particle diameter 10 to 100 nm [NC(0.01-0.1)]) and accumulation mode particles (100 to 1000 nm [NC(0.1-1)]) were monitored at a central site. Levels of particulate air pollution 2 days before the clinic visit were significantly associated with increased risk of ST-segment depression during exercise test. The association was most consistent for measures of particles reflecting accumulation mode particles (odds ratio 3.29; 95% CI, 1.57 to 6.92 for NC(0.1-1) and 2.84; 95% CI, 1.42 to 5.66 for PM2.5), but ultrafine particles also had an effect (odds ratio 3.14; 95% CI, 1.56 to 6.32), which was independent of PM2.5. Also, gaseous pollutants NO2 and CO were associated with an increased risk for ST-segment depressions. No consistent association was observed for coarse particles. The associations tended to be stronger among subjects who did not use beta-blockers. CONCLUSIONS: The present results suggest that the effect of particulate air pollution on cardiovascular morbidity is at least partly mediated through increased susceptibility to myocardial ischemia.
Juha Pekkanen; Annette Peters; Gerard Hoek; Pekka Tiittanen; Bert Brunekreef; Jeroen de Hartog; Joachim Heinrich; Angela Ibald-Mulli; Wolfgang G Kreyling; Timo Lanki; Kirsi L Timonen; Esko Vanninen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  106     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-08-20     Completed Date:  2002-09-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  933-8     Citation Subset:  AIM; IM    
Unit of Environmental Epidemiology, National Public Health Institute, Kuopio, Finland.
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MeSH Terms
Air Pollutants / adverse effects*,  analysis
Coronary Disease / diagnosis*
Environmental Exposure
Exercise Test
Finland / epidemiology
Myocardial Ischemia / diagnosis,  epidemiology*,  etiology
Particle Size
Risk Assessment
Risk Factors
Reg. No./Substance:
0/Air Pollutants
Comment In:
Circulation. 2002 Aug 20;106(8):890-2   [PMID:  12186787 ]

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